@article{ref1,
title="Multiple fractures in the elderly",
journal="Journal of bone and joint surgery: British volume",
year="2012",
author="Court-Brown, Charles M. and McQueen, M. M. and Duckworth, A. D. and Aitken, Stuart A. and Clement, N. D.",
volume="94",
number="2",
pages="231-236",
abstract="We present the prevalence of multiple fractures in the elderly in a single catchment population of 780 000 treated over a 12-month period and describe the mechanisms of injury, common patterns of occurrence, management, and the associated mortality rate. A total of 2335 patients, aged ≥ 65 years of age, were prospectively assessed and of these 119 patients (5.1%) presented with multiple fractures. Distal radial (odds ratio (OR) 5.1, p < 0.0001), proximal humeral (OR 2.2, p < 0.0001) and pelvic (OR 4.9, p < 0.0001) fractures were associated with an increased risk of sustaining associated fractures. Only 4.5% of patients sustained multiple fractures after a simple fall, but due to the frequency of falls in the elderly this mechanism resulted in 80.7% of all multiple fractures. Most patients required admission (> 80%), of whom 42% did not need an operation but more than half needed an increased level of care before discharge (54%). The standardised mortality rate at one year was significantly greater after sustaining multiple fractures that included fractures of the pelvis, proximal humerus or proximal femur (p < 0.001). This mortality risk increased further if patients were < 80 years of age, indicating that the existence of multiple fractures after low-energy trauma is a marker of mortality.<p /> <p>Language: en</p>",
language="en",
issn="0301-620X",
doi="10.1302/0301-620X.94B2.27381",
url="http://dx.doi.org/10.1302/0301-620X.94B2.27381"
}